Efficacy, Commitment, and Collaborative Practice 1 Running head: EFFICACY, COMMITMENT, AND COLLABORATIVE PRACTICE How Efficacy Beliefs predict Collaborative Practice: a Two-wave Study among Intensive Care Unit (ICU) Nurses

Title. How Efficacy Beliefs predict Collaborative Practice: a Two-wave Study among Intensive Care Unit (ICU) Nurses. Aims. The aim of the present study was to investigate in what way Intensive Care Unit (ICU) nurses’ efficacy beliefs, i.e. beliefs on their work-related competences, and commitment to their work team are related to the quality of collaborative practice between ICU-nurses and physicians over time. Background. Recent empirical studies in the field of work and organizational psychology demonstrated that (professional) efficacy beliefs are reciprocally related to workers’ resources and well-being over time, resulting in a positive gain spiral. Moreover, there is ample evidence that workers’ affective commitment to their organization or work-team is related to desirable work behaviours such as citizenship behaviour. The present study aimed at integrating these two lines of research, and testing the resulting research model in an ICUsetting. Methods. A longitudinal design was applied to questionnaire data from the EURICUSproject. The study sample consisted of 372 nurses working in 29 different European Intensive Care Units. Data were collected in 1997 and 1998. More specifically, we tested the hypotheses that (i) the relationship between efficacy beliefs and collaborative practice is mediated by team commitment, and (ii) efficacy beliefs, team commitment and collaborative practice are reciprocally related. Results. Both hypotheses were supported by the results of Structural Equation Modelling, suggesting a potential positive gain spiral of efficacy beliefs. Efficacy, Commitment, and Collaborative Practice 3 Conclusion. The results of this study emphasize the importance of creating a work environment that is conducive to ICU-nurses’ professional efficacy beliefs, which could be achieved by providing them with sufficient resources to perform their job well. Efficacy, Commitment, and Collaborative Practice 4 SUMMARY STATEMENT What is already known about this topic • Efficacy beliefs are reciprocally related to job resources and to positive work-related well-being over time. • ICU-nurses’ level of affective commitment to their work team is positively related to ICU medical performance. What this paper adds • Affective commitment to the work team is a mediating factor in the reciprocal relationships between ICU-nurses’ efficacy beliefs and collaborative practice. • Strengthening ICU-nurses’ efficacy beliefs will enhance collaborative practice over time, whereas in turn high quality collaborative practice will boost ICU nurses’ efficacy beliefs as well. Implications for practice and/or policy • Health care institutions should create working environments that provide ICU-nurses with sufficient resources to perform their job well. • Further research is needed to design and evaluate interventions for the enhancement of collaborative practice in ICUs.